title: Perceptions and practice patterns of general gynecologists regarding urogynecology and pelvic reconstructive surgery.
abstract: OBJECTIVE
  The purpose of this study was to describe the current practice patterns of general gynecologists regarding management of various urogynecologic conditions.
  
  
  METHODS
  A 15-item Web-based survey was sent to obstetrician and gynecologists in 2011. Subjects who chose to participate answered questions about their comfort level with management of various urogynecologic conditions, their perceptions of the need for a pelvic reconstructive surgeon in their community, and when they feel it is appropriate to refer to a specialist.
  
  
  RESULTS
  Two hundred ninety-four obstetrics/gynecology generalists responded to the survey with overall 33% response rate. There was a wide range of comfort level depending on the complexity of the condition. Most of the subjects felt comfortable in the management of stress and urge incontinence, cystocele, rectocele, and uterine prolapse. On the other hand, most of the subjects were uncomfortable with management of intrinsic sphincter deficiency, fecal incontinence, recurrent incontinence after failed surgery, and complications of vaginal mesh surgery. In addition, there was wide variation in types of surgical options offered by different practitioners. When we compared the results by age, younger gynecologists have a smaller repertoire of procedures they offer for treatment of urogynecologic conditions. Burch colposuspension, uterosacral ligament suspension, and colpocleisis were performed more often by older surgeons than younger surgeons. On the other hand, cystoscopy was performed more commonly by the younger group.
  
  
  CONCLUSIONS
  Among general gynecologists, there is a wide range in both comfort level for management of different urogynecologic conditions and types of urogynecologic services performed.
authors.affiliation: Center for Female Pelvic Medicine and Reconstructive Surgery, Loma Linda University Gynecology and Obstetrics, Loma Linda, CA, USA. jujyune@llu.edu
authors.forename: Junchan Joshua
authors.initials: JJ
authors.lastname: Yune
authors.forename: Sam
authors.initials: S
authors.lastname: Siddighi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D006176:Gynecology; D006801:Humans; D008297:Male; D009774:Obstetrics; D018579:Patient Selection; D017773:Pelvic Floor / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010820:Physicians / Q000523:psychology; D010818:Practice Patterns, Physicians'; D019651:Plastic Surgery Procedures; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D013519:Urogenital Surgical Procedures